• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2743-2746
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• 2013

Background: Dilantin sodium (phenytoin) is an antiepileptic drug, which is routinely used to control generalized tonic clonic seizure and partial seizure episodes. A few case reports of oral squamous cell carcinomas arising from regions of phenytoin induced gingival overgrowth (GO), and overexpression of mitogenic factors and p53 have presented this condition as a pathology with potential to transform into malignancy. We recently investigated the genetic status of p53 and H-ras, which are known to be frequently mutated in Indian oral carcinomas in GO tissues and found them to only contain wild type sequences, which suggested a non-neoplastic nature of phenytoin induced GO. However, besides p53 and H-ras, other oncogenes and tumor suppressors such as PIK3CA, p14ARF, p16INK4a and $p21^{Waf1/Cip1}$, are frequently altered in oral squamous cell carcinoma, and hence are required to be analyzed in phenytoin induced GO tissues to be affirmative of its non-neoplastic nature. Methods: 100ng of chromosomal DNA isolated from twenty gingival overgrowth tissues were amplified with primers for exons 9 and 20 of PIK3CA, exons $1{\alpha}$, $1{\beta}$ and 2 of p16INK4a and p14ARF, and exon 2 of $p21^{Waf1/Cip1}$, in independent reactions. PCR amplicons were subsequently gel purified and eluted products were sequenced. Results: Sequencing analysis of the twenty samples of phenytoin induced gingival growth showed no mutations in the analyzed exons of PIK3CA, p14ARF, p16INK4a and $p21^{Waf1/Cip1}$. Conclusion: The present data indicate that the mutational alterations of genes, PIK3CA, p14ARF, p16INK4a and $p21^{Waf1/Cip1}$ that are frequently mutated in oral squamous cell carcinomas are rare in phenytoin induced gingival growth. Thus the findings provide further evidence that phenytoin induced gingival overgrowth as a non-neoplastic lesion, which may be considered as clinically significant given the fact that the epileptic patients are routinely administered with phenytoin for the rest of their lives to control seizure episodes.

• Journal of Periodontal and Implant Science
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• v.30 no.2
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• pp.471-482
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• 2000

Recent studies have demonstrated that smoking may be one of the most significant risk factors in the development and progression of periodontal disease. Reports have indicated that smoking causes gingival blood flow to be decreased. However, studies on the effects of smoking on gingival blood flow have yielded contradictory results. The purpose of the present study was to determine the effect of smoking on gingival blood flow. One hundred volunteers(fifty non-smokers and fifty smokers) with good general and periodontal health, aged twenties(non-smoker : 22-29 years, mean=25.36, smoker : 23-29 years, mean=26.64) were selected. Laser Doppler flowmetry (floLAB, Moor Instruments Ltd., England) was applied to measure the gingival blood flow of interdental papilla, marginal gingiva, attached gingiva and alveolar mucosa of left and right upper lateral incisors. In smokers, following an overnight abstinence from smoking, gingival blood flow was measured before smoking, immediately after smoking, 1-, 2-, 3-, 4-, 5- and 6- hour after smoking from 9 a.m. to 3:30 p.m. The difference of blood flow in each tissue of non-smokers and that of each measuring time and each tissue of smokers were statistically analyzed by one way ANOVA and Tukey test. And the difference of blood flow between smokers and nonsmokers in each tissue was statistically analyzed by t-test. The results were as follows : 1. Mean blood flow was highest in alveolar mucosa, followed by interdental papilla, attached gingiva and marginal gingiva in both smokers and nonsmokers. There was a statistically significant difference in each tissue(p<0.05) . 2. There was no consistent result between mean blood flow before smoking in smokers and that of nonsmokers in each tissue. 3. There was a statistically significant difference between gingival blood flow at measuring time point and gingival blood flow of smokers in each tissue(p<0.05). The present study suggested that smoking could alter the gingival blood flow, thus might be partly contributed to periodontal destruction.

• Journal of Periodontal and Implant Science
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• v.28 no.2
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• pp.309-320
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• 1998

The periodontal health has been evaluated clinically by various epidemiological indices, and in researches by measurement of gingival crevicular fluid. Laser Doppler flowmetry is a reliable and objective method that allows immediate measurement of erythrocyte flux in approximately one cubic mm of the capillary bed without disturbing the tissues. The purpose of the present study was to determine whether human gingival blood flow was different according to measuring area, measuring time, and sex or not. Forty volunteers with good general and periodontal health, aged early twenties and unmarried, were selected. Laser Doppler flowmetry($floLAB^{(R)}$, Moor Instruments Ltd., England) was applied to measure the gingival blood flow of marginal gingiva, interdental papilla, attached gingiva and alveolar mucosa. The blood flow of interdental papilla was measured at 9-10 AM, 1-2 PM, and 5-6 PM. The difference of blood flow according to measuring area and measuring time was statistically analyzed by one way AOVA and Dunkan test, and the difference of blood flow between men and women was statistically analyzed by t-test. (1) Mean blood flow was significantly higher in alveolar mucosa than in the gingiva(p<0.05), and there was no significant difference in blood flow between marginal gingiva and interdental papilla(p>0.1). (2) Mean blood flow was significantly higher at 5-6 PM than at 9-10 AM and 1-2 PM(p<0.05). But there was no significant difference in gingival blood flow between 9-10 AM and 1-2 PM(p>0.1). (3) There was no significant difference in gingival blood flow between men and women(p>0.1). The above results suggest that the measurment of gingival blood flow using laser Doppler flowmetry may be clinically applicable to early determination of gingival inflammation and evaluation of healing status, but further studies are necessary to standardize and simplify the measuring procedure.

• Journal of Korean society of Dental Hygiene
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• v.21 no.6
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• pp.695-701
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• 2021

Objectives: This study aimed to determine the effect of COVID-19-induced household economic deterioration on gingival pain and bleeding. Methods: Data from the 16th Adolescent Health Behavior Survey 2020 were used. A total of 57,925 adolescents were included in this cross-sectional study. We evaluated the worsening of the COVID-19-induced household economic situation, gingival pain, and bleeding. All surveys were assessed in a subjective non-face-to-face online interview. Data were analyzed using descriptive statistics, chi-squared tests, and logistic regression. Results: The overall prevalence of gingival pain and bleeding symptoms in the study population was 19.2%. People with COVID-19 were more likely to suffer from gingival pain and gingival bleeding than those who did not have economic deterioration due to COVID-19. There was no economic deterioration due to COVID-19 (aOR=1.048, 95% CI=1.034-1.227) and worsened very much (aOR=1.358, 95% CI=1.164-1.585). Conclusions: There were more cases of gingival pain and gingival bleeding, which are early symptoms of periodontal disease, in patients with COVID-19 compared to cases without deterioration of the household economic situation due to COVID-19. It is necessary to measure and study gingival bleeding objectively rather than relying on self-reports.

• Journal of Periodontal and Implant Science
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• v.45 no.6
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• pp.247-251
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• 2015

Purpose: This report describes a case of granulomatosis with polyangiitis (GPA) in which the gingival manifestation was crucial in both making an early diagnosis and possibly in deciding the approach to treatment. Methods: A 57-year-old sailor presented to the Department of Dentistry at Ulsan University Hospital complaining of gingival swelling since approximately 2 months. He had orofacial granulomatous lesions and the specific gingival manifestation of strawberry gingivitis. Results: The diagnosis of GPA was made on the basis of clinical symptoms and signs, and confirmed by the presence of the anti-neutrophil cytoplasmic antibody and a positive biopsy. The patient was admitted to the hospital and subsequently placed on a disease-modifying therapy regimen that included methotrexate and prednisone. Conclusions: Identification of the gingival manifestation of the disease permitted an early diagnosis and prompt therapy in a disease in which time is a crucial factor. Because of its rapid progression and potentially fatal outcome, an early diagnosis of GPA is important. Therefore, dentists should be aware of the oral signs and symptoms of such systemic diseases.

• Restorative Dentistry and Endodontics
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• v.36 no.6
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• pp.515-520
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• 2011

One of the most challenging task in closing anterior diastema is avoiding "black triangle" between the teeth. This paper reports a case that the closure of diastema in anterior teeth could be successfully accomplished using direct adhesive restorations and gingival recontouring. The traditional technique using Mylar strip was modified to increase the emergence profile with natural contours at the gingival-tooth interface. Mylar strip was extended out of the sulcus by approximately 1 mm high from the gingival margin, and a small cotton pellet was used to provide the emergence contour. This modified approach is acceptable for the clinical situation.

• Journal of Periodontal and Implant Science
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• v.41 no.6
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• pp.302-308
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• 2011

Purpose: The emergence profile concept of an implant restoration is one of the most important factors for the esthetics and health of peri-implant soft tissue. This paper reports on two cases of gingival recontouring by the fabrication of a provisional implant restoration to produce an optimal emergence profile of a definitive implant restoration. Methods: After the second surgery, a preliminary impression was taken to make a soft tissue working cast. A provisional crown was fabricated on the model. The soft tissue around the implant fixture on the model was trimmed with a laboratory scalpel to produce the scalloped gingival form. Light curing composite resin was added to fill the space between the provisional crown base and trimmed gingiva. After 4 to 6 weeks, the final impression was taken to make a definitive implant restoration, where the soft tissue and tooth form were in harmony with the adjacent tooth. Results: At the first insertion of the provisional restoration, gum bleaching revealed gingival pressure. Four to six weeks after placing the provisional restoration, the gum reformed with harmony between the peri-implant gingiva and adjacent dentition. Conclusions: Gingival recontouring with a provisional implant restoration is a non-surgical and non-procedure-sensitive method. The implant restoration with the optimal emergence profile is expected to provide superior esthetic and functional results.

• Journal of Periodontal and Implant Science
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• v.25 no.1
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• pp.121-132
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• 1995

Patients, who have gingival recession and complain of root sensitivity, or esthetic concerns, are candidates for root coverage. When free gingival grafting is used for complete root corverage, the results may not be entirely predictible unless the recession is shallow and narrow because a free gingival graft depends on collateral circulation from the lateral and apical parts of the recipient bed to survive over the avascular root. Various pedicle graft techniques can produce more esthetic results, but these procedures are only indicated when adequate donor tissues are available adjacent to the defect. This case report presents three cases for root coverage using the various connective tissue graft techniques. In the first case(Class III & IV), subepithelial connective tissue grafting was done and resulted in gingival coverage on the two-thirds of exposed root surface and blended with the adjacent tissue in color and texture. In the second case(Class I), connective tissue and partial thickness double pedicle graft resulted in complete coverage of denuded root surface. In the third case(Class I), recession was treated by supraperiosteal envelope technique. The root surface was covered completely and esthetically. Finally, the esthetics in both colors and tissue contours were acceptable to patients in all cases by the connective tissue grafting. However, in the case of the reduced interdental bone, the denuded root surfaces were hardly covered completely.

• Journal of Periodontal and Implant Science
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• v.24 no.2
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• pp.271-282
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• 1994

Active treatment of periodontal disease consists of plaque control by the patient, with root planing and surgery perfomed by the dental practitioner. Chlorhexidine rinse has been the most effective antiplaque agent available today and tetracycline has been the most favored antibiotics. Therefore, the purpose of this study was compared the different effect among groups(saline mouthrinse[group I], 0.125% chlorhexidine mouthrinse [groupII], and 0.125% chlorhexidine mouthrinse containing tetracycline[groupIII]) during the immediate post periodontal therapy. We assessed plaque index, gingival index, papillary bleediing index, gingival crevicular volume, periodontal attachment loss, and periodontal pocket depth in 3 sites per subject. The assessment was made at baseline. At 1 week after scaling, and at 2 weeks after curettage. All groups were clinically and statistically reduced plaque score, gingival score, papillary bleeding score, and gingival crevicular volume at 2 weeks after curettage. Group II was significantly reduced periodontal pocket depth.(P<0.05) At 1 week after scaling, al clinical index scores were reduced but not singificantly difference between the groups.(p>0.05) At 2 weeks after curettage, plaque score, gingival score and papillary bleeding score were significantly difference between the groups.(P<0.05) During the experimental period, gingiva was not damaged and stain of the tongue or teeth were not noted in all groups.

• Journal of Periodontal and Implant Science
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• v.43 no.1
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• pp.37-40
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• 2013

Purpose: The purpose of study was to compare blood glucose in capillary finger-prick blood and gingival crevice blood using a self-monitoring blood glucose device among patients with gingivitis or periodontitis. Methods: Thirty patients with gingivitis or periodontitis and bleeding on probing (BOP) were chosen. The following clinical periodontal parameters were noted: probing depth, BOP, gingival bleeding index, and periodontal disease index. Blood samples were collected from gingival crevicular blood (GCB) and capillary finger-prick blood (CFB). These samples were analyzed using a glucose self-monitoring device. Results: Descriptive statistical analysis has been carried out in the present study. Data were analyzed using a Pearson's correlation coefficient and Student's t-test. A r-value of 0.97 shows very strong correlation between CFB and GCB, which was statistically highly significant (P<0.0001). Conclusions: The authors conclude that GCB may serve as potential source of screening blood glucose during routine periodontal examination in populations with an unknown history of diabetes mellitus.